FOURTEEN CASES
CASE I
Philiscus lived by the wall. He took to his bed
with acute fever on the first day and sweating ;
night uncomfortable.
Second day. General exacerbation, later a small
clyster moved the bowels well. A restful night.
Third day. Early and until mid-day he appeared
to have lost the fever ; but towards evening acute
fever with sweating ; thirst ; dry tongue ; black urine.
An uncomfortable night, without sleep ; completely
out of his mind.
Fourth day. All symptoms exacerbated ; black
urine ; a more comfortable night, and urine of a
better colour.
Fifth day. About mid-day slight epistaxis of unmixed
blood. Urine varied, with scattered, round
particles suspended in it, resembling semen ; they
did not settle. On the application of a suppository
the patient passed, with flatulence, scanty excreta.
A distressing night, snatches of sleep, irrational talk ;
extremities everywhere cold, and would not get
warm again ; black urine ; snatches of sleep towards
dawn ; speechless ; cold sweat ; extremities livid.
About mid-day on the sixth day the patient died.
The breathing throughout, as though he were recollecting
to do it,
1 was rare and large.
Spleen
raised in a round swelling ; cold sweats all the
time. The exacerbations on even days.
CASE II
Silenus lived on Broadway near the place of
Eualcidas. After over-exertion, drinking, and exercises
[p. 189]
at the wrong time he was attacked by fever.
He began by having pains in the loins, with heaviness
in the head and tightness of the neck. From
the bowels on the first day there passed copious
discharges of bilious matter, unmixed, frothy, and
highly coloured. Urine black, with a black sediment ;
thirst ; tongue dry ; no sleep at night.
Second day. Acute fever, stools more copious,
thinner, frothy ; urine black ; uncomfortable night ;
slightly out of his mind.
Third day. General exacerbation ; oblong tightness
2
of the hypochondrium, soft underneath, extending
on both sides to the navel ; stools thin,
blackish ; urine turbid, blackish ; no sleep at night ;
much rambling, laughter, singing ; no power of
restraining himself.
Fourth day. Same symptoms.
Fifth day. Stools unmixed, bilious, smooth, greasy ;
urine thin, transparent ; lucid intervals.
Sixth day. Slight sweats about the head ; extremities
cold and livid ; much tossing ; nothing passed
from the bowels ; urine suppressed ; acute fever.
Seventh day. Speechless ; extremities would no
longer get warm ; no urine.
Eighth day. Cold sweat all over ; red spots with
sweat, round, small like acne, which persisted without
subsiding. From the bowels with slight stimulus
[p. 191]
there came a copious discharge of solid stools, thin,
3
as it were unconcocted, painful. Urine painful and
irritating. Extremities grow a little warmer ;
fitful sleep ; coma ; speechlessness ; thin, transparent
urine.
Ninth day. Same symptoms.
Tenth day. Took no drink ; coma ; fitful sleep.
Discharges from the bowels similar ; had a copious
discharge of thickish urine, which on standing left
a farinaceous, white deposit ; extremities again cold.
Eleventh day. Death.
From the beginning the breath in this case was
throughout rare and large. Continuous throbbing
of the hypochondrium ; age about twenty years.
CASE III
Herophon had acute fever ; scanty stools with
tenesmus at the beginning, afterwards becoming
thin, bilious and fairly frequent. No sleep ; urine
black and thin.
Fifth day. Deafness early in the day ; general
exacerbation ; spleen swollen ; tension of the hypochondrium ;
scanty black stools ; delirium.
Sixth day. Wandering talk ; at night sweat and
chill ; the wandering persisted.
Seventh Day. Chill all over ; thirst ; out of his
mind. During the night he was rational, and slept.
Eighth day. Fever ; spleen lessened ; quite
rational ; pain at first in the groin, on the side of
the spleen ; then the pains extended to both legs.
Night comfortable ; urine of a better colour, with a
slight deposit.
Ninth day. Sweat, crisis, intermission.
[p. 193]
On the fifth day after the crisis the patient
relapsed. Immediately the spleen swelled ; acute
fever ; return of deafness. On the third day after
the relapse the spleen grew less and the deafness
diminished, but there was pain in the legs. During
the night he sweated. The crisis was about the
seventeenth day. There was no delirium during
the relapse.
CASE IV
In Thasos the wife of Philinus gave birth to a
daughter. The lochial discharge was normal, and
the mother was doing well when on the fourteenth
day after delivery she was seized with fever attended
with rigor. At first she suffered in the stomach
and the right hypochondrium. Pains in the genital
organs. The discharge ceased. By a pessary these
troubles were eased, but pains persisted in the head,
neck and loins. No sleep ; extremities cold ; thirst ;
bowels burnt ; scanty stools ; urine thin, and at first
colourless.
Sixth day. Much delirium at night, followed by
recovery of reason.
Seventh day. Thirst ; stools scanty, bilious, highly
coloured.
Eighth day. Rigor ; acute fever ; many painful
convulsions ; much delirium. The application of a
suppository made her keep going to stool, and
there were copious motions with a bilious flux. No
sleep.
Ninth day. Convulsions.
Tenth day. Lucid intervals.
Eleventh day. Slept ; complete recovery of her
memory, followed quickly by renewed delirium.
[p. 195]
A copious passing of urine with convulsions--her
attendants seldom reminding her--which was white
and thick, like urine with a sediment and then
shaken ; it stood for a long time without forming a
sediment ; colour and consistency like that of the
urine of cattle. Such was the nature of the urine
that I myself saw.
About the fourteenth day there were twitchings
over all the body ; much wandering, with lucid
intervals followed quickly by renewed delirium.
About the seventeenth day she became speechless.
Twentieth day. Death.
CASE V
The wife of Epicrates, who lay sick near the
founder,
4 when near her delivery was seized with
severe rigor without, it was said, becoming warm,
and the same symptoms occurred on the following day.
On the third day she gave birth to a daughter, and
the delivery was in every respect normal. On the
second day after the delivery she was seized with
acute fever, pain at the stomach and in the genitals.
A pessary relieved these symptoms, but there was
pain in the head, neck and loins. No sleep. From
the bowels passed scanty stools, bilious, thin and
unmixed. Urine thin and blackish. Delirium on
the night of the sixth day from the day the fever
began.
Seventh day. All symptoms exacerbated ; sleeplessness ;
delirium ; thirst ; bilious, highly-coloured
stools.
Eighth day. Rigor ; more sleep.
Ninth day. The same symptoms.
[p. 197]
Tenth day. Severe pains in the legs ; pain again
at the stomach ; heaviness in the head ; no delirium ;
more sleep ; constipation.
Eleventh day. Urine of better colour, with a
thick deposit ; was easier.
Fourteenth day. Rigor ; acute fever.
Fifteenth day. Vomited fairly frequently bilious,
yellow vomit ; sweated without fever ; at night, however,
acute fever ; urine thick, with a white sediment.
Sixteenth day. Exacerbation ; an uncomfortable
night ; no sleep ; delirium.
Eighteenth day. Thirst ; tongue parched ; no
sleep ; much delirium ; pain in the legs.
About the twentieth day. Slight rigors in the
early morning ; coma ; quiet sleep ; scanty, bilious,
black vomits ; deafness at night.
About the twenty-first day. Heaviness all over
the left side, with pain ; slight coughing ; urine
thick, turbid, reddish, no sediment on standing.
In other respects easier ; no fever. From the
beginning she had pain in the throat ; redness ; uvula
drawn back ; throughout there persisted an acrid
flux, smarting, and salt.
About the twenty-seventh day. No fever ; sediment
in urine ; some pain in the side.
About the thirty-first day. Attacked by fever ;
bowels disordered and bilious.
Fortieth day. Scanty, bilious vomits.
Eightieth day. Complete crisis with cessation of
fever.
CASE VI
Cleanactides, who lay sick above the temple of
Heracles, was seized by an irregular fever. He had
[p. 199]
at the beginning pains in the head and the left side,
and in the other parts pains like those caused by
fatigue. The exacerbations of the fever were varied
and irregular ; sometimes there were sweats, sometimes
there were not. Generally the exacerbations
manifested themselves most on the critical days.
About the twenty-fourth day. Pain in the hands ;
bilious, yellow vomits, fairly frequent, becoming after
a while like verdigris ; general relief.
About the thirtieth day. Epistaxis from both
nostrils began, and continued, irregular and slight,
until the crisis. All the time he suffered no thirst,
nor lack of appetite or sleep. Urine thin, and not
colourless.
About the fortieth day. Urine reddish, and with
an abundant, red deposit. Was eased. Afterwards
the urine varied, sometimes having, sometimes not
having, a sediment.
Sixtieth day. Urine had an abundant sediment,
white and smooth ; general improvement ; fever
intermitted ; urine again thin but of good colour.
Seventieth day. Fever, which intermitted for
ten days.
Eightieth day. Rigor ; attacked by acute fever ;
much sweat ; in the urine a red, smooth sediment.
A complete crisis.
CASE VII
Meton was seized with fever, and painful heaviness
in the loins.
Second day. After a fairly copious draught of
water had his bowels well moved.
Third day. Heaviness in the head ; stools thin,
bilious, rather red.
[p. 201]
Fourth day. General exacerbation ; slight epistaxis
twice from the right nostril. An uncomfortable
night ; stools as on the third day ; urine rather
black ; had a rather black cloud floating in it, spread
out, which did not settle.
Fifth day. Violent epistaxis of unmixed blood
from the left nostril ; sweat ; crisis. After the crisis
sleeplessness ; wandering ; urine thin and rather
black. His head was bathed ; sleep ; reason restored.
The patient suffered no relapse, but after
the crisis bled several times from the nose.
CASE VIII
Erasinus lived by the gully of Boétes. Was seized
with fever after supper ; a troubled night.
First day. Quiet, but the night was painful.
Second day. General exacerbation ; delirium at
night.
Third day. Pain and much delirium.
Fourth day. Very uncomfortable ; no sleep at
night ; dreams and wandering. Then worse
symptoms, of a striking and significant character ;
fear and discomfort.
Fifth day. Early in the morning was composed,
and in complete possession of his senses. But long
before mid-day was madly delirious ; could not
restrain himself ; extremities cold and rather livid ;
urine suppressed ; died about sunset.
In this patient the fever was throughout accompanied
by sweat ; the hypochondria were swollen,
distended and painful. Urine black, with round,
suspended particles which did not settle. There
were solid discharges from the bowels. Thirst
[p. 203]
throughout not very great. Many convulsions with
sweating about the time of death.
CASE IX
Crito, in Thasos, while walking about, was seized
with a violent pain in the great toe. He took to bed
the same day with shivering and nausea ; regained
a little warmth ; at night was delirious.
Second day. Swelling of the whole foot, which
was rather red about the ankle, and distended ;
black blisters ; acute fever ; mad delirium. Alvine
discharges unmixed, bilious and rather frequent.
He died on the second day from the commencement.
CASE X
The man of Clazomenae, who lay sick by the well
of Phrynichides, was seized with fever. Pain at the
beginning in head, neck and loins, followed immediately
by deafness. No sleep ; seized with acute
fever ; hypochondrium swollen, but not very much ;
distension ; tongue dry.
Fourth day. Delirium at night.
Fifth day. Painful.
Sixth day. All symptoms exacerbated.
About the eleventh day slight improvement.
From the beginning to the fourteenth day there
were from the bowels thin discharges, copious, of
a watery biliousness ; they were well supported by
the patient. Then the bowels were constipated.
Urine throughout thin, but of good colour. It had
much cloud spread through it, which did not
settle in a sediment. About the sixteenth day the
urine was a little thicker, and had a slight sediment.
[p. 205]
The patient became a little easier, and was more
rational.
Seventeenth day. Urine thin again ; painful swellings
by both ears. No sleep ; wandering ; pain in
the legs.
Twentieth day. A crisis left the patient free
from fever ; no sweating ; quite rational. About
the twenty-seventh day violent pain in the right
hip, which quickly ceased. The swellings by the
ears neither subsided nor suppurated, but continued
painful. About the thirty-first day diarrhéa with
copious, watery discharges and signs of dysentery.
Urine thick ; the swellings by the ears subsided.
Fortieth day. Pain in the right eye ; sight rather
impaired ; recovery.
CASE XI
The wife of Dromeades, after giving birth to a
daughter, when everything had gone normally, on
the second day was seized with rigor ; acute fever.
On the first day she began to feel pain in the region
of the hypochondrium ; nausea ; shivering ; restless ;
and on the following days did not sleep. Respiration
rare, large, interrupted at once as by an inspiration.
5
Second day from rigor. Healthy action of the
bowels. Urine thick, white, turbid, like urine
which has settled, stood a long time, and then
been stirred up. It did not settle. No sleep at
night.
Third day. At about mid-day rigor ; acute fever ;
urine similar ; pain in the hypochondrium ; nausea ;
an uncomfortable night without sleep ; a cold sweat
all over the body, but the patient quickly recovered
heat.
[p. 207]
Fourth day. Slight relief of the pains about the
hypochondrium ; painful heaviness of the head ;
somewhat comatose ; slight epistaxis ; tongue dry ;
thirst ; scanty urine, thin and oily ; snatches of sleep.
Fifth day. Thirst ; nausea ; urine similar ; no
movement of the bowels ; about mid-day much
delirium, followed quickly by lucid intervals ; rose,
but grew somewhat comatose ; slight chilliness ;
slept at night ; was delirious.
Sixth day. In the morning had a rigor ; quickly
recovered heat ; sweated all over ; extremities cold ;
was delirious ; respiration large and rare. After a
while convulsions began from the head, quickly
followed by death.
CASE XII
A man dined when hot and drank too much.
During the night he vomited everything ; acute
fever ; pain in the right hypochondrium ; inflammation,
soft underneath, from the inner part
6; an
uncomfortable night ; urine at the first thick and
red ; on standing it did not settle ; tongue dry ; no
great thirst.
Fourth day. Acute fever ; pains all over.
Fifth day. Passed much smooth, oily urine ;
acute fever.
Sixth day. In the afternoon much delirium. No
sleep at night.
Seventh day. General exacerbation ; urine similar ;
much rambling ; could not restrain himself ; on
stimulation the bowels passed watery, disturbed
discharges, with worms. An uncomfortable night,
with rigor in the morning. Acute fever. Hot
sweat, and the patient seemed to lose his fever ;
[p. 209]
little sleep, followed by chilliness ; expectoration.
In the evening much delirium, and shortly afterwards
he vomited black, scanty, bilious vomits.
Ninth day. Chill ; much wandering ; no sleep.
Tenth day. Legs painful ; general exacerbation ;
wandering.
Eleventh day. Death.
CASE XIII
A woman lying sick by the shore, who was three
months gone with child, was seized with fever, and
immediately began to feel pains in the loins.
Third day. Pain in the neck and in the head,
and in the region of the right collar-bone. Quickly
she lost her power of speech, the right arm was
paralyzed, with a convulsion, after the manner of
a stroke ; completely delirious. An uncomfortable
night, without sleep ; bowels disordered with bilious,
unmixed, scanty stools.
Fourth day. Her speech was recovered, but was
indistinct ; convulsions ; pains of the same parts
remained ; painful swelling in the hypochondrium ;
no sleep ; utter delirium ; bowels disordered ; urine
thin, and not of good colour.
Fifth day. Acute fever ; pain in the hypochondrium ;
utter delirium ; bilious stools. At night
sweated ; was without fever.
Sixth day. Rational ; general relief, but pain
remained about the left collar-bone ; thirst ; urine
thin ; no sleep.
Seventh day. Trembling ; some coma ; slight
delirium ; pains in the region of the collar-bone
and left upper arm remained ; other symptoms
[p. 211]
relieved ; quite rational. For three days there
was an intermission of fever.
Eleventh day. Relapse ; rigor ; attack of fever.
But about the fourteenth day the patient vomited
bilious, yellow matter fairly frequently ; sweated ;
a crisis took off the fever.
CASE XIV
Melidia, who lay sick by the temple of Hera,
began to suffer violent pain in the head, neck and
chest. Immediately she was attacked by acute
fever, and there followed a slight menstrual flow.
There were continuous pains in all these parts.
Sixth day. Coma ; nausea ; shivering ; flushed
cheeks ; slight delirium.
Seventh day. Sweat ; intermittence of fever ; the
pains persisted ; relapse ; snatches of sleep ; urine
throughout of good colour but thin ; stools thin,
bilious, irritating, scanty, black and of bad odour ;
sediment in the urine white and smooth ; sweating.
Eleventh day. Perfect crisis.
